Attachment 33 Attachment 33 Additional healthcare Section

Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC)

Attachment 33 Additional healthcare Section

MEPS-HC Core Interview

OMB: 0935-0118

Document [pdf]
Download: pdf | pdf
SpecWriter Data

Form Version:

9/15/2017 1:26:52 PM

Report Type:

Full Detail

Project Database:
Language:

English

WESSQL6.MEPS_V2

Spec Label:

This is the cover page. Additional contents currently project specific.

AH - Page 1 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Rout

Full Detail Spec
BOX_00

Route Details:

(AH1000)

Item Type: Route

Type Class: If Then

01 Box = BOX_10, BOX_20, BOX_30, BOX_40, BOX_50, BOX_60, BOX_70, BOX_80, BOX_
90, BOX_100, BOX_110, BOX_120
02 Loop = LOOP_10
03 End Loop = END_LP10
04 Single Select = AH10, AH40, AH90, AH100, AH110, AH120
05 Single Select with Display Roster = AH70
10 Multiple Select with Fill in Answer Text = AH80
19 Numeric Field = AH20, AH30, AH50, AH60

BOX_10

Route Details:

(AH1005)

Item Type: Route

Type Class: If Then

Context header display instructions:
Display Person.FullName, BegRefM, BegRefD, BegRefY, EndRefM, EndRefD, EndRefY.
General Display Instructions for Question Text:
For '{PERSON'S START DATE}', display the person level reference period PERSON’S START
DATE. Display as full month, xx, YYYY - e.g., "January 1, 2016". Use variables BegRefM,
BegRefD, BegRefY.
For '{PERSON’S END DATE}', display the person level reference period PERSON’S END
DATE. Display as full month, xx, YYYY - e.g., "January 1, 2016". Use variables EndRefM,
EndRefD, EndRefY.

BOX_20

Route Details:

(AH1010)

Item Type: Route

Type Class: If Then

Note: The following section is for:
-all persons and
- for all rounds
This section is part of the larger person level looping that includes the PM, OM, AH, CS,
and QS sections.
Continue to BOX_30.

AH - Page 2 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Rout

Full Detail Spec

BOX_30

Route Details:

(AH1015)

Type Class: If Then

If person is < or = 15 years old (or age category 3), go to BOX_70.
Otherwise, continue with AH10.

AH10
Item Type:

(AH1025)
Question

Type Class:

Enumerated

Answer Type:

TDAYSINHOSP

Help Available (HALFDAYHelp
Context Header:

Item Type: Route

BLAISE NAME: MissWork
Field kind: Datafield

ArrayMin:

Min value:

ArrayMax:

Max value:

Field Size:
Answers allowed: 1

Show Card (

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
{NUMBER OF DAYS IN HOSPITAL: {NUMBER OF DAYS}}
{NUMBER OF DAYS INSTITUTIONALIZED: {NUMBER OF DAYS}}
{The next questions ask about time/Now think about} when {you/{PERSON}} may have missed a half day or
more from work {since {PERSON’S START DATE}/between {PERSON’S START DATE} and {PERSON’S END DATE}}.
{In answering these questions, please include any time when this occurred because of {your/{PERSON}' s}
physical illness or injury, or a mental or emotional problem such as stress or depression.}
{Including the time {you/{PERSON}} {were/was} in {the hospital} {and} {the long-term care facility}, how/How}
many days did {you/{PERSON}} miss a half day or more from work {since {PERSON’S START DATE}/ between
{PERSON’S START DATE} and {PERSON’S END DATE}}? Please do not include work around the house.
PROBE: Include any time when a half day or more was missed because of a physical illness or injury, or a mental
or emotional problem.
HELP: F1

Responses:

RECORD NUMBER OF DAYS
NO DAYS MISSED FROM WORK
DOES NOT WORK (OTHER THAN
AROUND THE HOUSE)
REFUSED
DON'T KNOW

1
2
3

AH20
BOX_50
BOX_50

(AH1030)
(AH1045)
(AH1045)

RF
DK

BOX_50
BOX_50

(AH1045)
(AH1045)

AH - Page 3 of 19

MEPS_V2
Full Detail Spec

Display
Instructions:

Additional Healthcare Questions (AH) Section
(Que

Display ‘NUMBER OF DAYS IN HOSPITAL: { }’ if person has at least one hospital stay that
ended in current round (i.e., discharge date not coded ‘95’ (STILL IN HOSPITAL)). Otherwise,
use a null display.
For ‘NUMBER OF DAYS’, display total number of days person was in hospital for all hospital
stays that ended in current round (i.e., discharge date not coded ‘95’ (STILL IN HOSPITAL)).
Otherwise, use a null display.
Display 'NUMBER OF DAYS INSTITUTIONALIZED: { }' if person has at least one institutional
stay (IC event) that ended in current round (i.e., discharge date not coded '95' (STILL IN
INSTITUTION)). Otherwise, use a null display.
For 'NUMBER OF DAYS', display total number of days person was in an institution for all
institutional stays that ended in current round (i.e., discharge date not coded '95' (STILL IN
INSTITUTION)). Otherwise, use a null display.
Display 'The next questions ask about time' if first time through the Additional Healthcare
Questions (AH) Section in the current round. Otherwise, display 'Now think about'.
Display 'since {PERSON’S START DATE}' if not round 5. Display 'between {PERSON’S START
DATE} and {PERSON’S END DATE}' if round 5.
Display 'In answering . . . or depression.' if first time through the AH section in the current
round. Otherwise, use a null display.
Display 'Including the time {you/{person}} {were/was} in {the hospital} {and} {the long- term
care facility}, how' if person has at least one hospital stay (HS) or one institutional stay (IC)
event that ended in current round (i.e., discharge date not coded '95' (STILL IN HOSPITAL/
INSTITUTION)). Otherwise, display 'How'.
Display 'the hospital' if person has at least one hospital stay (HS) event that ended in the
current round. Otherwise, use a null display.
Display 'the long-term care facility' if person has at least one institutional care (IC) event that
ended in the current round. Otherwise, use a null display.
Display 'and' if person has both a hospital stay (HS) event and an institutional care (IC) event
that both ended in the current round. Otherwise, use a null display.

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

AH - Page 4 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec
AH20
Item Type:
Type Class:
Answer Type:

(AH1030)
Question
Integer

Field kind: Datafield
Field Size: 3

{Continuous Answer.} Answers allowed: 1

Help Available (HALFDAYHelp
Context Header:

BLAISE NAME: NoWork
ArrayMin:

Min value: -99

ArrayMax:

Max value: 999

Show Card (

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
{NUMBER OF DAYS IN HOSPITAL: {NUMBER OF DAYS}}
{NUMBER OF DAYS INSTITUTIONALIZED: {NUMBER OF DAYS}}
[{The next questions ask about time/Now think about} when {you/{PERSON}} may have missed a half day or
more from work {since {PERSON’S START DATE}/between {PERSON’S START DATE} and {PERSON’S END DATE}}.
{In answering these questions, please include any time when this occurred because of {your/{PERSON}' s}
physical illness or injury, or a mental or emotional problem such as stress or depression.}
{Including the time {you/{PERSON}} {were/was} in {the hospital} {and} {the long -term care facility}, how/How}
many days did {you/{PERSON}} miss a half day or more from work {since {PERSON’S START DATE}/ between
{PERSON’S START DATE} and {PERSON’S END DATE}}? Please do not include work around the house.
PROBE: Include any time when a half day or more was missed because of a physical illness or injury, or a mental
or emotional problem.]
ENTER NUMBER OF DAYS
HELP: F1

BOX_40

Responses:

AH - Page 5 of 19

(AH1035)

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec

Programmer
Instructions:

Hard Checks:
1. RF/DK not allowed. If RF/DK coded here display the following message: “REFUSED AND
DON’T KNOW DISALLOWED. IF NUMBER OF DAYS MISSED FROM WORK IS UNKNOWN,
SELECT REFUSED OR DON’T KNOW AT PREVIOUS QUESTION (AH10-MissWork).”
2. ‘0’ not allowed. If ‘0’ entered, display the following message: "IF NO DAYS MISSED FROM
WORK, SELECT CODE 2 'NO DAYS MISSED FROM WORK' AT PREVIOUS QUESTION (AH10MissWork).”
3. 1 through number of days in person’s reference period allowed. If number entered >
number of days in person’s reference period, display the following message: “NUMBER OF
DAYS MUST BE EQUAL TO OR LESS THAN NUMBER IN {PERSON}’S REFERENCE PERIOD.”

Display
Instructions:

Testing/Editing
Notes:

BOX_40

Route Details:

Display “{The next questions … around the house” and the PROBE in lighter grayed out text
and in brackets. Display AH10 and AH20 on the same form pane.
See AH10 for other display instructions.

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

(AH1035)

Item Type: Route

Type Class: If Then

If round 3, continue with AH30.
Otherwise (i.e., if not round 3), go to BOX_50.

AH - Page 6 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec
AH30
Item Type:
Type Class:
Answer Type:

Help Available (
Context Header:

(AH1040)
Question
Integer

BLAISE NAME: MissWorkYr
Field kind: Datafield
Field Size: 3

{Continuous Answer.} Answers allowed: 1

)

Show Card (

ArrayMin:

Min value: 0

ArrayMax:

Max value: 996

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
NUMBER OF DAYS MISSED WORK: {NUMBER OF DAYS}
Of those days, how many were in {YEAR}?
ENTER NUMBER OF DAYS

Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:

Display
Instructions:

RF
DK

BOX_50

(AH1045)

BOX_50
BOX_50

(AH1045)
(AH1045)

Hard Check:
Days missed from work in {YEAR} entered at AH30 must be < or = total days missed from
work entered at AH20. If AH30 > AH20, display the following message: “DAYS MISSED
IN {YEAR} MUST BE LESS THAN OR EQUAL TO TOTAL NUMBER OF DAYS
MISSED FROM WORK.”

For 'NUMBER OF DAYS,' display the number entered at AH20.
(For specifications purposes only; CAPI handles automatically): 'YEAR' in question text is first
calendar year of panel (FirstPanYear).

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

AH - Page 7 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Rout

Full Detail Spec
BOX_50

Route Details:

(AH1045)

Item Type: Route

Type Class: If Then

If AH10 is coded '3' (DOES NOT WORK (OTHER THAN AROUND THE HOUSE)),
go to BOX_70.
Otherwise, continue with AH40.

AH40
Item Type:

(AH1050)
Question

Type Class:

Enumerated

Answer Type:

TYESNO_DD

BLAISE NAME: MissWorkOth
Field kind: Datafield

Help Available (HALFDAYHelp
Context Header:

ArrayMin:

Min value:

ArrayMax:

Max value:

Field Size:
Answers allowed: 1

Show Card (

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
{Besides the {NUMBER OF MISSED WORK DAYS} days {you/{PERSON}} missed a half day or more from
work because of {your/his/her} own illness or injury, did/Did} {you/{PERSON}} miss more than a half day from
work {between {PERSON’S START DATE} and {PERSON’S END DATE}} because of someone else's illness,
injury, or health care needs, for example, to take care of a sick child or a relative?
HELP: F1

Responses:

YES
NO/DO NOT WORK
REFUSED
DON'T KNOW

1
2
RF
DK

AH - Page 8 of 19

AH50
BOX_70
BOX_70
BOX_70

(AH1055)
(AH1070)
(AH1070)
(AH1070)

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec

Display
Instructions:

Display ‘Besides the ..., did’ if AH10 is coded ‘1’ (RECORD NUMBER OF DAYS).
Otherwise, display ‘Did’.
For ‘NUMBER OF MISSED WORK DAYS’, display number recorded at AH20.
Display 'between {PERSON’S START DATE} and {PERSON’S END DATE}' if round 5. Otherwise,
use a null display.

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

BLAISE NAME: DaysOth

AH50
Item Type:

(AH1055)
Question

Type Class:

Integer

Answer Type:

{Continuous Answer.} Answers allowed: 1

Help Available (HALFDAYHelp
Context Header:

Field kind: Datafield

ArrayMin:

Min value: 1

ArrayMax:

Max value: 996

Field Size: 3

Show Card (

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
How many days did {you/{PERSON}} miss a half day or more from work because of someone else's illness,
injury, or health care needs?
ENTER NUMBER OF DAYS
HELP: F1

Responses:
REFUSED
DON'T KNOW

RF
DK

AH - Page 9 of 19

BOX_60

(AH1060)

BOX_70
BOX_70

(AH1070)
(AH1070)

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec

Programmer
Instructions:

Hard Checks:
1. ‘0’ not allowed. If ‘0’ entered, display the following message: “IF NO WORK DAYS
MISSED, BACK UP AND CORRECT PREVIOUS ANSWER (AH40-MissWorkOth).”
2. 1 through number of days in person’s reference period allowed. If number entered at
AH50 > number of days in person’s reference period, display the following message:
“NUMBER OF DAYS MUST BE EQUAL TO OR LESS THAN NUMBER IN {PERSON}’S REFERENCE
PERIOD.”

Display
Instructions:

Testing/Editing
Notes:

BOX_60

Route Details:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

(AH1060)

Item Type: Route

Type Class: If Then

If round 3, continue with AH60.
Otherwise (i.e., if not round 3), go to BOX_70.

AH - Page 10 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec
AH60
Item Type:
Type Class:
Answer Type:

Help Available (
Context Header:

(AH1065)
Question
Integer

BLAISE NAME: DaysOthYr
Field kind: Datafield
Field Size: 3

{Continuous Answer.} Answers allowed: 1

)

Show Card (

ArrayMin:

Min value: 0

ArrayMax:

Max value: 996

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:
NUMBER OF DAYS MISSED WORK DUE TO SOMEONE ELSE'S HEALTH: {NUMBER OF DAYS}
Of those days, how many were in {YEAR}?
ENTER NUMBER OF DAYS

Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:

Display
Instructions:

RF
DK

BOX_70

(AH1070)

BOX_70
BOX_70

(AH1070)
(AH1070)

Hard Check:
Days in missed from work in {YEAR} entered at AH60 must be < or = days missed work due
to someone else's health at AH50. If AH60 > AH50, display the following message: “DAYS
MISSED IN {YEAR} MUST BE LESS THAN OR EQUAL TO TOTAL NUMBER OF
DAYS MISSED FROM WORK DUE TO SOMEONE ELSE’S HEALTH.”

For “NUMBER OF DAYS”, display the number entered at AH50.
(For specifications purposes only; CAPI handles automatically): 'YEAR' in question text is first
calendar year of panel (FirstPanYear).

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

AH - Page 11 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Rout

Full Detail Spec
BOX_70

Route Details:

(AH1070)

Item Type: Route

Type Class: If Then

If at least one condition on person’s-medical-conditions-roster meets the following
conditions:
⦁ Condition was ‘created’ during the current round (RndCreated=current round).
⦁ Condition is not a priority condition, that is, condition was not created in the PE
section.
⦁ If Condition[I].DeleteFlg≠Ye
s
 
a
nd
⦁ If the Condition[I]SelectRnd_UT=current round or Condition[I]
SelectRnd_PM=current round, or both, then
Continue with AH70.
Otherwise, go to BOX_100.

AH70
Item Type:
Type Class:

(AH1075)
Question

Answer Type:

TYESNO

Enumerated

Help Available (ConInjHelp)
Context Header:

BLAISE NAME: CondInj
Field kind: Datafield
ArrayMin:
Field Size:
Answers allowed: 1

ArrayMax:

Show Card (

Min value:
Max value:

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
Now I'm going to read you a list of some of the health conditions that were reported for {you/{PERSON}}
between {PERSON’S START DATE} and {PERSON’S END DATE}.
READ CONDITIONS BELOW.
{Medical Condition}1
{Medical Condition}2
{Medical Condition}3
{Medical Condition}4
{Medical Condition}N
{Was this health condition/Were any of these health conditions} due to an accident or injury?
HELP: F1

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK
AH - Page 12 of 19

BOX_100
BOX_100
BOX_100

(AH1110)
(AH1110)
(AH1110)

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec

Programmer
Instructions:

Roster behavior:
1. Select, add, delete, and edit disallowed.
If coded ‘1’ (YES) and only 1 condition eligible for display at AH70, auto-code that condition
at AH80 and go to BOX_80. If coded ‘1’ (YES) and more than 1 condition eligible for display
at AH70, continue with AH80.

Display
Instructions:

Roster 1- Report
Roster Definition:
This item displays the person's-conditions-roster.
Roster filter:
Display only the conditions for person that meet the following conditions:
⦁ Condition was ‘created’ during the current round (RndCreated=current round).
⦁ Condition is not a priority condition, that is, condition was not created in the PE section.
Display 'was this health condition' if only one condition eligible for display at AH70.
Otherwise, display 'were any of these health conditions'.

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

AH - Page 13 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec
AH80
Item Type:
Type Class:
Answer Type:

(AH1080)
Question
Enumerated
TCONDITION

BLAISE NAME: Injury
Field kind: Datafield

Field Size:
Answers allowed: 99 ArrayMax:

Help Available (ConInjHelp)
Context Header:

ArrayMin:

Show Card (

Min value:
Max value:

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
Which of {your/{PERSON}'s} health conditions were due to an accident or injury?
PROBE: Any other health conditions due to an accident or injury?
ENTER ALL THAT APPLY
HELP: F1

Responses:

{MEDICAL CONDITION} 1
{MEDICAL CONDITION} 2
{MEDICAL CONDITION} 3
{MEDICAL CONDITION} 4
{MEDICAL CONDITION}N

Programmer
Instructions:

Roster Behavior:
1. Multiple select allowed.
2. Select, add, delete, and edit disallowed.

Display
Instructions:

1
2
3
4
5

BOX_80
BOX_80
BOX_80
BOX_80
BOX_80

(AH1085)
(AH1085)
(AH1085)
(AH1085)
(AH1085)

Roster 2- no add/edit/delete
Roster Definition:
Display the person-medical-conditions-roster for selection.
Roster Filter:
Display conditions that meet the following:
⦁ Condition was ‘created’ during the current round (RndCreated=current round).
⦁ Condition is not a priority condition, that is, condition was not created in the PE section.

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

AH - Page 14 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Rout

Full Detail Spec
BOX_80

Route Details:

(AH1085)

Item Type: Route

Type Class: If Then

If person is = or > 16 years of age or in age categories 4-9, continue with BOX_90.
Otherwise, go to BOX_100.

BOX_90

Route Details:

LOOP_10

Route Details:

(AH1090)

Item Type: Route

Type Class: If Then

If at least one condition selected (or auto-coded) at AH80, continue with LOOP_10.
Otherwise, go to BOX_100.

(AH1095)

Item Type: Route

Type Class: Begin Loop

For each element in person’s-medical-conditions-roster, ask AH90 - END_LP10.
Loop definition: LOOP_10 collects information about medical conditions created during
the current round that are due to an accident or injury. This loop cycles on medical
conditions that meet the following conditions:
⦁ Condition was selected (or auto-coded) at AH80 in the current round (condition is due
to an accident or injury)
⦁ Condition was ‘created’ during the current round (RndCreated=current round).

AH - Page 15 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec
AH90
Item Type:

(AH1100)
Question
Enumerated

Type Class:
Answer Type:

{User Defined.}

Help Available (
Context Header:

BLAISE NAME: InjWork
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

)

Show Card (

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME} {CONDITION} {PERS STR-DT}
{PERS END-DT}

Question Text:
{You indicated that {you/{PERSON}} {are/is} not working now. Did the {CONDITION} happen while
{you/{PERSON}} {were/was} at work on any previous job?/Did the {CONDITION} happen while
{you/{PERSON}} {were/was} at work?}

Responses:

Display
Instructions:

YES
NO
DOES NOT WORK
REFUSED
DON'T KNOW

1
2
3
RF
DK

END_LP10
END_LP10
END_LP10
END_LP10
END_LP10

(AH1105)
(AH1105)
(AH1105)
(AH1105)
(AH1105)

Display "You indicated that {you/{PERSON}}...previous job?" if AH10 is coded '3' (DOES
NOT WORK (OTHER THAN AROUND THE HOUSE)). Otherwise, display “Did the
{CONDITION} happen while {you/{PERSON}} {were/was} at work?”
For “{CONDITION}”, display the name of the medical condition being looped on.

Testing/Editing
Notes:

END_LP10

Route Details:

Variable collected at MEPSSpring2018.AH_Main.AH_Loop10[1..100]
Variable stored at MEPSSpring2018.AH_Main.AH_Loop10[1..100]

(AH1105)

Item Type: Route

Type Class: End Loop

Cycle on next condition in person’s-medical-conditions-roster that meets the conditions
stated in the loop definition.
If no other conditions meet the stated conditions, end LOOP_10 and continue with BOX_
100.

AH - Page 16 of 19

MEPS_V2

Additional Healthcare Questions (AH) Section
(Rout

Full Detail Spec

BOX_100

(AH1110)

(AH1115)

Route Details:

AH100
Item Type:
Type Class:
Answer Type:

Help Available (
Context Header:

Type Class: If Then

If rounds 3 or 5, continue with BOX_110.
Otherwise (i.e., if rounds 1, 2, or 4), go to BOX_120.

Route Details:

BOX_110

Item Type: Route

Item Type: Route

Type Class: If Then

If person is = or > 18 years of age or in age categories 4-9, continue with AH100.
Otherwise, go to BOX_120.

(AH1120)
Question
Enumerated
TYESNO

)

BLAISE NAME: AllTeeth
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (

)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
The next few questions ask you to consider {your/{PERSON’s}} health.
{Have/Has} {you/{PERSON}} lost all of {your/his/her} upper and lower natural (permanent) teeth?

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

AH - Page 17 of 19

AH110
AH110
AH110
AH110

(AH1125)
(AH1125)
(AH1125)
(AH1125)

)

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

AH110
Item Type:

(AH1125)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (ExerActHelp)
Context Header:

BLAISE NAME: Exer5Days
Field kind: Datafield

ArrayMin:

Min value:

ArrayMax:

Max value:

Field Size:
Answers allowed: 1

Show Card (

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
{Do/Does} {you/{PERSON}} now spend half an hour or more in moderate or vigorous physical activity at least
five times a week?
HELP: F1

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

AH - Page 18 of 19

AH120
AH120
AH120
AH120

(AH1130)
(AH1130)
(AH1130)
(AH1130)

MEPS_V2

Additional Healthcare Questions (AH) Section
(Que

Full Detail Spec
AH120
Item Type:

(AH1130)
Question
Enumerated

Field kind: Datafield

Field Size:
TFREQUENCY_DAY Answers allowed: 1

Type Class:
Answer Type:

Help Available (
Context Header:

BLAISE NAME: OFtSmoke

)

Show Card (

ArrayMin:

Min value:

ArrayMax:

Max value:

)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:
{Do/Does} {you/{PERSON}} now smoke cigarettes every day, some days or not at all?

Responses:

EVERY DAY
SOME DAYS
NOT AT ALL
REFUSED
DON'T KNOW

1
2
3
RF
DK

BOX_120
BOX_120
BOX_120
BOX_120
BOX_120

Display
Instructions:

Testing/Editing
Notes:

BOX_120

Route Details:

Variable collected at MEPSSpring2018.AH_Main
Variable stored at MEPSSpring2018_PersSect.AH_Main

(AH1135)

Item Type: Route

Type Class: If Then

End of section. Continue to the next section of the questionnaire.

[End of AH]

AH - Page 19 of 19

(AH1135)
(AH1135)
(AH1135)
(AH1135)
(AH1135)

)


File Typeapplication/pdf
File Modified2018-02-21
File Created2017-09-15

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